How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $263.03 | Professional | None | $213.80 | $213.80 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $467.74 | Professional | None | $323.59 | $323.59 | $467.74 |
BCBS Arizona Setting Facility Modifier None Typical Low $141.25 Median $645.65 Typical High $977.24 | Facility | None | $141.25 | $645.65 | $977.24 |
BCBS Arizona Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $851.14 | Professional | None | $416.87 | $467.74 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $537.03 Typical High $2,187.76 | Facility | None | $229.09 | $537.03 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $2,570.40 | Professional | None | $190.55 | $251.19 | $2,570.40 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $316.23 | Professional | None | $186.21 | $208.93 | $316.23 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $21.38 |
Where Arizona sits
The same service costs 2.6 times more in Hawaii than in Arizona. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arizona· 51st of 51
$229
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.